Multicomponent Interdisciplinary Group Intervention for Self-Management of Fibromyalgia: A Mixed-Methods Randomized Controlled Trial
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{"title"=>"Multicomponent interdisciplinary group intervention for self-management of fibromyalgia: A mixed-methods randomized controlled trial", "type"=>"journal", "authors"=>[{"first_name"=>"Patricia", "last_name"=>"Bourgault", "scopus_author_id"=>"23968927600"}, {"first_name"=>"Anaïs", "last_name"=>"Lacasse", "scopus_author_id"=>"23095175600"}, {"first_name"=>"Serge", "last_name"=>"Marchand", "scopus_author_id"=>"7004320633"}, {"first_name"=>"Roxanne", "last_name"=>"Courtemanche-Harel", "scopus_author_id"=>"56584521200"}, {"first_name"=>"Jacques", "last_name"=>"Charest", "scopus_author_id"=>"6701425877"}, {"first_name"=>"Isabelle", "last_name"=>"Gaumond", "scopus_author_id"=>"16244805800"}, {"first_name"=>"Juliana Barcellos", "last_name"=>"De Souza", "scopus_author_id"=>"24921194800"}, {"first_name"=>"Manon", "last_name"=>"Choinière", "scopus_author_id"=>"7004702487"}], "year"=>2015, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84929334168", "sgr"=>"84929334168", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0126324", "pmid"=>"25978402", "isbn"=>"1932-6203", "pui"=>"604392691"}, "id"=>"e9a0d686-29d0-3b96-ac48-a6873c8a6222", "abstract"=>"BACKGROUND: This study evaluated the efficacy of the PASSAGE Program, a structured multicomponent interdisciplinary group intervention for the self-management of FMS.\\n\\nMETHODS: A mixed-methods randomized controlled trial (intervention (INT) vs. waitlist (WL)) was conducted with patients suffering from FMS. Data were collected at baseline (T0), at the end of the intervention (T1), and 3 months later (T2). The primary outcome was change in pain intensity (0-10). Secondary outcomes were fibromyalgia severity, pain interference, sleep quality, pain coping strategies, depression, health-related quality of life, patient global impression of change (PGIC), and perceived pain relief. Qualitative group interviews with a subset of patients were also conducted. Complete data from T0 to T2 were available for 43 patients.\\n\\nRESULTS: The intervention had a statistically significant impact on the three PGIC measures. At the end of the PASSAGE Program, the percentages of patients who perceived overall improvement in their pain levels, functioning and quality of life were significantly higher in the INT Group (73%, 55%, 77% respectively) than in the WL Group (8%, 12%, 20%). The same differences were observed 3 months post-intervention (Intervention group: 62%, 43%, 38% vs Waitlist Group: 13%, 13%, 9%). The proportion of patients who reported ≥50% pain relief was also significantly higher in the INT Group at the end of the intervention (36% vs 12%) and 3 months post-intervention (33% vs 4%). Results of the qualitative analysis were in line with the quantitative findings regarding the efficacy of the intervention. The improvement, however, was not reflected in the primary outcome and other secondary outcome measures.\\n\\nCONCLUSION: The PASSAGE Program was effective in helping FMS patients gain a sense of control over their symptoms. We suggest including PGIC in future clinical trials on FMS as they appear to capture important aspects of the patients' experience.\\n\\nTRIAL REGISTRATION: International Standard Randomized Controlled Trial Number Register ISRCTN14526380.", "link"=>"http://www.mendeley.com/research/multicomponent-interdisciplinary-group-intervention-selfmanagement-fibromyalgia-mixedmethods-randomi", "reader_count"=>58, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Librarian"=>2, "Student > Doctoral Student"=>5, "Researcher"=>9, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>7, "Other"=>1, "Student > Master"=>10, "Student > Bachelor"=>9, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Professor > Associate Professor"=>1, "Librarian"=>2, "Student > Doctoral Student"=>5, "Researcher"=>9, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>7, "Other"=>1, "Student > Master"=>10, "Student > Bachelor"=>9, "Lecturer"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>5, "Nursing and Health Professions"=>14, "Mathematics"=>1, "Medicine and Dentistry"=>16, "Neuroscience"=>1, "Psychology"=>16, "Social Sciences"=>4, "Earth and Planetary Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>16}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>4}, "Psychology"=>{"Psychology"=>16}, "Earth and Planetary Sciences"=>{"Earth and Planetary Sciences"=>1}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>14}, "Mathematics"=>{"Mathematics"=>1}, "Unspecified"=>{"Unspecified"=>5}}, "group_count"=>10}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/2070741"], "description"=>"<p>Timeline of data collection in each study group.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417184, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.g002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Timeline_of_data_collection_in_each_study_group_/1417184", "title"=>"Timeline of data collection in each study group.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070743"], "description"=>"<p>Percentage of patients in the Intervention and Waitlist Groups who reported that their pain, functioning and quality of life improved (slightly, greatly, or considerably) at T1 compared to baseline (T0) on the Patient Global Impression of Change Scales.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417186, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.g003", "stats"=>{"downloads"=>5, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Percentage_of_patients_in_the_Intervention_and_Waitlist_Groups_who_reported_that_their_pain_functioning_and_quality_of_life_improved_slightly_greatly_or_considerably_at_T1_compared_to_baseline_T0_on_the_Patient_Global_Impression_of_Change_Scales_/1417186", "title"=>"Percentage of patients in the Intervention and Waitlist Groups who reported that their pain, functioning and quality of life improved (slightly, greatly, or considerably) at T1 compared to baseline (T0) on the Patient Global Impression of Change Scales.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070745"], "description"=>"<p>Percentage of patients in the Intervention Group who reported that their condition (pain, functioning and quality of life) continued to improve or remained stable 3 months after the intervention (T2) compared to the Waitlist Group on the Patient Global Impression of Change Scales.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417188, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.g004", "stats"=>{"downloads"=>1, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Percentage_of_patients_in_the_Intervention_Group_who_reported_that_their_condition_pain_functioning_and_quality_of_life_continued_to_improve_or_remained_stable_3_months_after_the_intervention_T2_compared_to_the_Waitlist_Group_on_the_Patient_Global_Impres/1417188", "title"=>"Percentage of patients in the Intervention Group who reported that their condition (pain, functioning and quality of life) continued to improve or remained stable 3 months after the intervention (T2) compared to the Waitlist Group on the Patient Global Impression of Change Scales.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070747"], "description"=>"<p>NRS = Numerical Rating Scale (higher scores indicate greater pain intensity); FIQ = Fibromyalgia Impact Questionnaire (higher scores indicate greater FMS severity); CSQ = Coping Strategies Questionnaire (higher scores indicate greater use of the strategy/coping efforts); PCS = Pain Catastrophizing Scale (higher scores reflect greater pain catastrophizing).</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417190, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.g005", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Mean_scores_and_their_Standard_Errors_in_the_Intervention_Group_at_baseline_T0_at_the_end_of_the_intervention_T1_and_at_3_6_and_12_months_thereafter_T2_T3_T4_/1417190", "title"=>"Mean scores and their Standard Errors in the Intervention Group at baseline (T0), at the end of the intervention (T1), and at 3, 6, and 12 months thereafter (T2, T3, T4).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070748"], "description"=>"<p>CBT = Cognitive Behavioral Therapy.</p><p>* Except for Session 1, all educational sessions start with a brief overview of the participants’ preceding week(s) (e.g, achievements).</p><p><sup>£</sup> At the time of the very first appointment with the participants, those assigned to the Intervention Group were provided with a brief personalised exercise program based on the results of their physical evaluation.</p><p><sup>α</sup> Starting on Session 3, patient-tailored exercise programs are put in place and are practiced at the beginning of each session. Participants are encouraged to carry out their exercise program 20 min per day, 6 times a week.</p><p><sup>§</sup> Participants are invited to pick up one cardiorespiratory activity of their choice (e.g., swimming, walking, etc) and practice it for 20 minutes, 3 times a week.</p><p><sup>ϕ</sup> Starting at Session 4, participants are introduced and trained in using different types of relaxation techniques. Participants choose the technique they prefer and are encouraged to do a relaxation session at home 3 times a week</p><p><sup>Ψ</sup> At Week 6, 8, and 10, there is no session. These break periods provide the participants time to practice/integrate newly acquired self-management strategies and consolidate the exercises/relaxation programs at home</p><p>Summary of the components and content of the PASSAGE Program.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417191, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.t001", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_the_components_and_content_of_the_PASSAGE_Program_/1417191", "title"=>"Summary of the components and content of the PASSAGE Program.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070749"], "description"=>"<p>Data are presented as mean ± standard deviation values, or number of patients and percentage.</p><p>INT Group: Intervention Group</p><p>WL Group: Waitlist Group</p><p>NRS = Numerical rating scale</p><p>OTC = Over-the-counter</p><p>*Living with children (n = 1), parents (n = 3), or brothers/sisters (n = 1)</p><p><sup>†</sup>Retired, students, volunteer work</p><p>Characteristics of the participants who completed the baseline evaluation.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417192, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.t002", "stats"=>{"downloads"=>1, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_participants_who_completed_the_baseline_evaluation_/1417192", "title"=>"Characteristics of the participants who completed the baseline evaluation.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070750"], "description"=>"<p>* Data are presented as mean ± standard deviation values.</p><p>** P-values are presented for the <i>Group x Time</i> effect and show whether the mean scores across time depended or not upon the intervention. The first line presents unadjusted mixed model p-values while the second line are the p-values for gender and study site adjusted model and the fully adjusted model (study site, gender, living arrangements, work status, pain duration and use of pain medication). All models are Kenward-Roger adjusted.</p><p>BPI = Brief Pain Inventory; higher scores indicate more pain interference with various aspects of daily living; BDI = Beck Depression Inventory; higher scores indicate more severe depressive symptoms; CPSI = Chronic Pain Sleep Inventory; Overall Sleep Quality item: higher scores indicate better sleep quality; Sleep Problem Index score: higher scores indicate greater problems; CSQ = Coping Strategy Questionnaire: higher scores on ignoring pain sensations, diverting attention, reinterpreting pain sensations, and praying subscales indicate greater use of the coping strategy; higher scores on the catastrophizing subscale indicate a greater tendency to catastrophize; FIQ = Fibromyalgia Impact Questionnaire: higher scores indicate greater FMS severity; PCS = Pain Catastrophizing Scale: higher scores indicate a greater tendency to catastrophize in the face of pain;</p><p>SF-12v2 = 12-Item Short Form Health Survey version 2: higher scores indicate better health-related quality of life.</p><p>Magnitude and significance of the improvements in the intervention (INT, n = 28) and the waitlist (WL, n = 29) groups up to three months post-intervention.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417193, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.t003", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Magnitude_and_significance_of_the_improvements_in_the_intervention_INT_n_28_and_the_waitlist_WL_n_29_groups_up_to_three_months_post_intervention_/1417193", "title"=>"Magnitude and significance of the improvements in the intervention (INT, n = 28) and the waitlist (WL, n = 29) groups up to three months post-intervention.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070762", "https://ndownloader.figshare.com/files/2070763", "https://ndownloader.figshare.com/files/2070764", "https://ndownloader.figshare.com/files/2070765"], "description"=>"<div><p>Background</p><p>This study evaluated the efficacy of the PASSAGE Program, a structured multicomponent interdisciplinary group intervention for the self-management of FMS.</p><p>Methods</p><p>A mixed-methods randomized controlled trial (intervention (INT) vs. waitlist (WL)) was conducted with patients suffering from FMS. Data were collected at baseline (T<sub>0</sub>), at the end of the intervention (T<sub>1</sub>), and 3 months later (T<sub>2</sub>). The primary outcome was change in pain intensity (0-10). Secondary outcomes were fibromyalgia severity, pain interference, sleep quality, pain coping strategies, depression, health-related quality of life, patient global impression of change (PGIC), and perceived pain relief. Qualitative group interviews with a subset of patients were also conducted. Complete data from T<sub>0 </sub>to T<sub>2 </sub>were available for 43 patients.</p><p>Results</p><p>The intervention had a statistically significant impact on the three PGIC measures. At the end of the PASSAGE Program, the percentages of patients who perceived overall improvement in their pain levels, functioning and quality of life were significantly higher in the INT Group (73%, 55%, 77% respectively) than in the WL Group (8%, 12%, 20%). The same differences were observed 3 months post-intervention (Intervention group: 62%, 43%, 38% vs Waitlist Group: 13%, 13%, 9%). The proportion of patients who reported ≥50% pain relief was also significantly higher in the INT Group at the end of the intervention (36% vs 12%) and 3 months post-intervention (33% vs 4%). Results of the qualitative analysis were in line with the quantitative findings regarding the efficacy of the intervention. The improvement, however, was not reflected in the primary outcome and other secondary outcome measures.</p><p>Conclusion</p><p>The PASSAGE Program was effective in helping FMS patients gain a sense of control over their symptoms. We suggest including PGIC in future clinical trials on FMS as they appear to capture important aspects of the patients’ experience.</p><p>Trial registration</p><p>International Standard Randomized Controlled Trial Number Register <a href=\"http://www.controlled-trials.com/ISRCTN14526380\" target=\"_blank\">ISRCTN14526380</a></p></div>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417201, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0126324.s001", "https://dx.doi.org/10.1371/journal.pone.0126324.s002", "https://dx.doi.org/10.1371/journal.pone.0126324.s003", "https://dx.doi.org/10.1371/journal.pone.0126324.s004"], "stats"=>{"downloads"=>4, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Multicomponent_Interdisciplinary_Group_Intervention_for_Self_Management_of_Fibromyalgia_A_Mixed_Methods_Randomized_Controlled_Trial_/1417201", "title"=>"Multicomponent Interdisciplinary Group Intervention for Self-Management of Fibromyalgia: A Mixed-Methods Randomized Controlled Trial", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2015-05-15 03:50:08"}
  • {"files"=>["https://ndownloader.figshare.com/files/2070740"], "description"=>"<p>SH = Sherbrooke study site; RN = Rouyn-Noranda study site.</p>", "links"=>[], "tags"=>["isrctn", "wl", "PGIC", "Qualitative group interviews", "int", "43 patients.ResultsThe intervention", "outcome measures.ConclusionThe PASSAGE Program", "PASSAGE Program", "vs", "Multicomponent Interdisciplinary Group Intervention", "FMS patients gain"], "article_id"=>1417183, "categories"=>["Uncategorised"], "users"=>["Patricia Bourgault", "Anaïs Lacasse", "Serge Marchand", "Roxanne Courtemanche-Harel", "Jacques Charest", "Isabelle Gaumond", "Juliana Barcellos de Souza", "Manon Choinière"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0126324.g001", "stats"=>{"downloads"=>2, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_of_participants_through_the_study_at_each_assessment_point_/1417183", "title"=>"Flow of participants through the study at each assessment point.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2015-05-15 03:50:08"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"15", "full-text"=>"14", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"13", "full-text"=>"16", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}
  • {"unique-ip"=>"14", "full-text"=>"12", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"9"}
  • {"unique-ip"=>"17", "full-text"=>"14", "pdf"=>"9", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"10"}
  • {"unique-ip"=>"5", "full-text"=>"6", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"12"}

Relative Metric

{"start_date"=>"2015-01-01T00:00:00Z", "end_date"=>"2015-12-31T00:00:00Z", "subject_areas"=>[]}
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